The long range goals of this project are to improve the oral health of older women through identifying the risks to oral health posed by osteoporosis and aging. This research will ultimately suggest interventions to prevent or mitigate the consequences of oral disease associated with the highly prevalent postmenopausal osteoporosis found in older women. To achieve these goals, the University of Pittsburgh Oral Health Science Institute (OHSI) has been invited by the University's Graduate School of Public Health to establish an oral health component within a large ongoing multicenter epidemiologic study of aged women. This NIH funded project entitled "The Study of Osteoporotic Fractures" (SOF) is a prospective study initiated in 1986 on a cohort of 9704 community-dwelling women greater than or equal to 65 years of age. Extensive information has been collected on the cohort in terms of: bone mineral density, systemic factors associated with bone metabolism, medical and functional ability, fracture history, diet, and systemic fluoride exposure. This small grant application specifically aims to determine:: (1) if osteoporotic women are at greater risk for tooth loss and residual ridge resorption, (2) if osteoporosis affects the severity of periodontal disease, (3) if osteoporotic women have decreased access to professional dental services. In addition, this application will provide a baseline clinical examination to be used for a subsequent longitudinal study. Hypotheses generated from this study will be addressed in a subsequent FIRST Award or R01 application. This application seeks support for two years for a cross-sectional oral health assessment component to be added to the Pittsburgh cohort of the SOF (n=2401). A clinical examination will be conducted on a subsample (n=600) of subjects during the next examination cycle of the SOF. Oral health data will be collected on: tooth loss, residual ridge resorption, periodontal disease, Xerostomia, oral soft tissue pathology, caries and dental prosthesis use and complications. A questionnaire will assess utilization of dental services, attitudes about oral health, and perceived need for dental care. Associations between osteoporosis, oral health, and access to dental care will be determined. Based on these associations, the risk posed to oral health and access to dental care by osteoporotic changes in bone will be estimated. The results will enhance our understanding of age related oral changes, provide insight into minimizing barriers to dental care for elderly women, and suggest areas for future research. The relevance of this project is extremely high. Over 62% of the over 65 years old population are women, with osteoporosis affecting women at six times the rate of men and resulting in a majority of women suffering some osteoporotic complication by age 75. The high prevalence of osteoporosis in women over 65 (25-40%) may portend a significant and growing dental health problem.